Medtech Insight is part of Informa PLC

This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC’s registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.

This copy is for your personal, non-commercial use. For high-quality copies or electronic reprints for distribution to colleagues or customers, please call +44 (0) 20 3377 3183

Printed By

UsernamePublicRestriction
UsernamePublicRestriction

Imaging Use Assumption Increase Crops Up In Physician Fee Proposal

This article was originally published in The Gray Sheet

Executive Summary

Whether or not Congress fulfills promises to enact medical imaging physician payment cuts next year, CMS said July 1 that it plans to do just that through its own administrative means

You may also be interested in...



CMS spares radiation payments, delays imaging cuts

The utilization rate assumption used to calculate Medicare payments for scans with advanced diagnostic imaging equipment selling for more than $1 million will increase from 50% to 90% under CMS' 2010 final physician fee schedule, issued Oct. 30. The change, which will significantly reduce per-scan physician payments, will be phased in over a period of four years rather than being imposed all at once in January 2010, as originally proposed 1("The Gray Sheet" July 6, 2009). Radiation oncology equipment was spared in the ruling, with CMS saying it will not apply the change to expensive therapeutic equipment, as it would have in the July 1 proposed fee schedule. But Medicare imaging physician payment policy may ultimately be determined by Congress. Pending health care reform bills in the House and Senate would mandate increased imaging utilization rate assumptions, but not by as high as 90% (2"The Gray Sheet" Sept. 21, 2009)

CMS spares radiation payments, delays imaging cuts

The utilization rate assumption used to calculate Medicare payments for scans with advanced diagnostic imaging equipment selling for more than $1 million will increase from 50% to 90% under CMS' 2010 final physician fee schedule, issued Oct. 30. The change, which will significantly reduce per-scan physician payments, will be phased in over a period of four years rather than being imposed all at once in January 2010, as originally proposed 1("The Gray Sheet" July 6, 2009). Radiation oncology equipment was spared in the ruling, with CMS saying it will not apply the change to expensive therapeutic equipment, as it would have in the July 1 proposed fee schedule. But Medicare imaging physician payment policy may ultimately be determined by Congress. Pending health care reform bills in the House and Senate would mandate increased imaging utilization rate assumptions, but not by as high as 90% (2"The Gray Sheet" Sept. 21, 2009)

Senators oppose radiation cuts

Sens. Blanche Lincoln., D-Ark., and Richard Burr, R-N.C., lead a bipartisan group of 32 senators on a letter to Health and Human Services Sept. 23 opposing proposed cuts to radiation oncology services in CMS' draft 2010 physician fee schedule. The proposal would change the assumed Medicare utilization rate from 50% to 90% for equipment valued at more than $1 million per unit, effectively reducing the per-scan payment for services including magnetic resonance imaging and cancer radiation treatments. The bipartisan letter points out that the use rate change is based on a Medicare Payment Advisory Commission recommendation targeting diagnostic imaging, not radiation oncology, which is hit with a 19% cut in the proposal (1"The Gray Sheet" July 6, 2009)

Related Content

Topics

UsernamePublicRestriction

Register

LL1134882

Ask The Analyst

Ask the Analyst is free for subscribers.  Submit your question and one of our analysts will be in touch.

Your question has been successfully sent to the email address below and we will get back as soon as possible. my@email.address.

All fields are required.

Please make sure all fields are completed.

Please make sure you have filled out all fields

Please make sure you have filled out all fields

Please enter a valid e-mail address

Please enter a valid Phone Number

Ask your question to our analysts

Cancel